Gudis David A, Patel Krishna G
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Curr Opin Otolaryngol Head Neck Surg. 2014 Aug;22(4):260-6. doi: 10.1097/MOO.0000000000000066.
The optimal timing and techniques utilized to address the nasal deformity of the cleft lip continue to raise challenges and debate for the surgical community. There has been a shift in the paradigm addressing the nasal deformity to a more proactive approach. The goal of this article is to provide an update of the latest techniques for primary cleft rhinoplasty.
A medical literature search was performed specifically targeting primary cleft rhinoplasty in order to review the current strategies implemented, including presurgical orthopedics, surgical incisions, reconstruction, and suture techniques.
Today primary rhinoplasty is performed widely with many investigators reporting improved esthetic and functional outcomes. Both endonasal and external rhinoplasty approaches have been described for the unilateral and bilateral deformity. Goals include closure of the nasal floor and sill, symmetry of the alar base, and symmetry of the lower lateral cartilages with appropriate projection of the dome. Recent literature supports that rhinoplasty performed at the time of the primary cleft lip closure may reduce the frequency and magnitude of required intermediate and definitive rhinoplasty operations.
处理唇裂鼻畸形所采用的最佳时机和技术，持续给外科界带来挑战并引发争论。处理鼻畸形的模式已转向更积极主动的方法。本文的目的是提供一期唇裂鼻整形术最新技术的最新情况。
专门针对一期唇裂鼻整形术进行了医学文献检索，以回顾当前实施的策略，包括术前矫形、手术切口、重建和缝合技术。
如今，一期鼻整形术已广泛开展，许多研究者报告称其在美学和功能方面的效果有所改善。针对单侧和双侧畸形，均描述了鼻内和鼻外鼻整形术方法。目标包括封闭鼻底和鼻槛、鼻翼基部对称以及下外侧软骨对称且穹窿有适当的突出度。近期文献支持在一期唇裂修复时进行鼻整形术可能会减少所需的二期和最终鼻整形术操作的频率和程度。
